Neurological Complications of Liver Cirrhosis and Orthotopic Liver Transplant

Ardizzone, G; Arrigo, Alessandro; Schellino, Mm; Stratta, Chiara; Valzan, S; Skurzak, Stefano; Andruetto, P.; Panio, Angelo; Ballaris, M.A.; Lavezzo, Bruna; Salizzoni, Mauro; Cerutti, Elisabetta

doi:10.1016/j.transproceed.2006.01.039

Cited by 61 publications

(42 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The highest rate was observed in the first month after LT, which is compatible with previous reports in the literature. [11][12][13][14][15] We did not find a significant correlation between primary liver disease and NCs. Some of the results reported in the literature resemble ours; however, Lewis and associates found a higher incidence in patients with alcoholic liver disease and those with primary biliary cirrhosis.…”

Section: Discussioncontrasting

confidence: 74%

Neurologic Complications After Liver Transplant: Experience at a Single Center

Derle

Kibaroğlu²,

Öcal³

et al. 2015

Exp Clin Transplant

View full text Add to dashboard Cite

Objectives: Neurologic complications occur frequently after liver transplants. Up to 43% of patients experience severe postsurgical neurologic complications. These complications are significantly associated with longer hospital stay, morbidity, and mortality. The aim of this retrospective study was to evaluate the type and incidence of neurologic complications after liver transplants in adult patients. Materials and Methods:We retrospectively evaluated the medical records of 176 adult patients who had undergone liver transplants between 1995 and 2013. We recorded the demographic data, type of neurologic complications, type, and level of immunosuppressive treatment, and cause of liver failure. Results: Our study sample consisted of 48 deceaseddonor liver transplants and 128 living-donor transplants (n = 176). Fifty-three of the patients (30.1%) were female. The age range of the total sample was 18 to 66 years (mean age, 43.1 ± 13.7 y). As immunosuppressive treatment, most patients received tacrolimus alone (52%) or tacrolimus combined with mycophenolate mofetil (33%). Neurologic complications occurred in 74 of the patients (42%). The most common neurologic complications were diffuse encephalopathy (22.2%) and seizure (14.2%). Other neurologic complications were posterior reversible encephalopathy (1.7%), peripheral neuropathy (1.7%), cerebrovascular disease (1.1%), and central nervous system infection (1.1%). Age, cause of liver failure, and type of transplant were not associated with occurrence of neurologic complications. Conclusions: There was a high incidence of neurologic complications after liver transplants. Diffuse encephalopathy and seizure were common complications. Physicians should be aware of the high risk of neurologic complications after liver transplants. Factors such as immunosuppressive toxicity and metabolic imbalance that predispose patients to neurologic complications after liver transplants should be evaluated immediately, and treatment of postoperative neurologic complications should be initiated as early as possible.

show abstract

Section: Discussioncontrasting

confidence: 74%

Neurologic Complications After Liver Transplant: Experience at a Single Center

Derle

Kibaroğlu²,

Öcal³

et al. 2015

Exp Clin Transplant

View full text Add to dashboard Cite

show abstract

“…More specifically, those patients presented with more corpus callosum, WM, BG, and hippocampus lesions. Patients with liver disease or those who had transplantation are more at risk for developing CNS complications, including ODS, probably secondary to metabolic and cerebral hemodynamic derangements 47,48 that might render osmotic regulatory mechanisms insufficient. Hippocampal lesions were reported in more than one-third of patients and were associated with higher initial Na ϩ levels.…”

Section: Osmotic Demyelination Syndromementioning

confidence: 99%

Clinical Semiology and Neuroradiologic Correlates of Acute Hypernatremic Osmotic Challenge in Adults: A Literature Review

Ismail¹,

Szóllics

Szólics

et al. 2013

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

SUMMARY:The complex interplay between hypernatremic osmotic disturbances and cerebral lesions is yet to be clarified. In this review, we discuss, on the basis of the reported data of hypernatremic CNS challenge in the adult population, the clinical and radiologic features of the condition. Our search captured 20 case studies and 1 case series with 30 patients in total who acquired acute hypernatremia due to different etiologies and developed CNS lesions. We explored the associations between premorbid conditions, clinical presentation, hypernatremic state, correction rate, and radiologic appearance, including the localization of brain lesions and the outcomes. The results revealed that altered mental status was the most commonly reported symptom and osmotic demyelination syndrome in the form of extrapontine myelinolysis was the prevailing radiologic pattern. Finally, we contrasted, when appropriate, clinical and experimental data related to hypernatremic and hyponatremic osmotic insults to aid the understanding of the pathophysiology of CNS osmotic brain injury.ABBREVIATIONS: BG ϭ basal ganglia; CPM ϭ central pontine myelinolysis; EPM ϭ extrapontine myelinolysis; GCS ϭ Glasgow Coma Scale; ODS ϭ osmotic

show abstract

“…13 Neurologic complications are multifactorial, with insufficient graft function, intracranial bleeding, cerebral infarcts, infections, and immunosuppressive drug toxicity (tacrolimus and cyclosporine) considered among these factors. 13,14 As in our patients, most neurologic complications can be successfully treated by correcting the underlying factor.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Demir

Özbek²,

Bora³

et al. 2016

Exp Clin Transplant

View full text Add to dashboard Cite

The widespread use of immunosuppressive agents has significantly increased the rates of successful solid-organ and stem cell transplants, especially with liver and kidney. Cyclosporine and tacrolimus are most commonly used for this purpose. Although these agents have different mechanisms of action, both have various adverse effects, including nausea, vomiting, headache, hypertension, nephrotoxicity, and rarely epileptic seizures. In our first case, a patient presented with epileptic seizures and hemiparesis after a liver transplant, and posterior reversible encephalopathy syndrome related to cyclosporine toxicity was considered. Once cyclosporine levels in the blood decreased, the patient had both clinical and radiologic improve ments.In our second case, a patient presented with delirium after a liver transplant. Again, when cyclosporine levels in the blood decreased, the patient showed improvement in clinical findings. Neurologic com plications may develop after liver transplant, and these complications are encountered most frequently within the first postoperative month. Neurologic complications are multifactorial; insuf ficient graft function, intracranial bleeding, cerebral infarcts, infections, and immuno suppressive drug toxicity (tacrolimus and cyclosporine) may be considered among these factors. As shown in our presented cases, most neurologic complications can be successfully treated by correcting the underlying factor.

show abstract

Neurological Complications of Liver Cirrhosis and Orthotopic Liver Transplant

Cited by 61 publications

References 22 publications

Neurologic Complications After Liver Transplant: Experience at a Single Center

Neurologic Complications After Liver Transplant: Experience at a Single Center

Clinical Semiology and Neuroradiologic Correlates of Acute Hypernatremic Osmotic Challenge in Adults: A Literature Review

Untitled

Contact Info

Product

Resources

About